Anorexia nervosa – Symptoms and causes

Risk factors

Certain risk factors increase the risk of anorexia nervosa, including:

  • Being female. Anorexia is more common in girls and women. However, boys and men have been increasingly developing eating disorders, perhaps because of growing social pressures.
  • Young age. Anorexia is more common among teenagers. Still, people of any age can develop this eating disorder, though it’s rare in those over 40. Teens may be more susceptible because of all the changes their bodies go through during puberty. They also may face increased peer pressure and be more sensitive to criticism or even casual comments about weight or body shape.
  • Genetics. Changes in certain genes may make people more susceptible to anorexia.
  • Family history. Those with a first-degree relative — a parent, sibling or child — who had the disease have a much higher risk of anorexia.
  • Weight changes. When people change weight — on purpose or unintentionally — those changes may be reinforced by positive comments from others for losing weight or by negative remarks for gaining weight. Such changes and comments may trigger someone to start dieting to an extreme. In addition, starvation and weight loss may change the way the brain works in vulnerable individuals, which may perpetuate restrictive eating behaviors and make it difficult to return to normal eating habits.
  • Transitions. Whether it’s a new school, home or job; a relationship breakup; or the death or illness of a loved one, change can bring emotional stress and increase the risk of anorexia.
  • Sports, work and artistic activities. Athletes, actors, dancers and models are at higher risk of anorexia. Coaches and parents may inadvertently raise the risk by suggesting that young athletes lose weight.
  • Media and society. The media, such as TV and fashion magazines, frequently feature a parade of skinny models and actors. These images may seem to equate thinness with success and popularity. But whether the media merely reflect social values or actually drive them isn’t clear-cut.

Complications

Anorexia nervosa can have numerous complications. At its most severe, it can be fatal. Death may occur suddenly — even when someone is not severely underweight. This may result from abnormal heart rhythms (arrhythmias) or an imbalance of electrolytes — minerals such as sodium, potassium and calcium that maintain the balance of fluids in your body.

Other complications of anorexia include:

  • Anemia
  • Heart problems, such as mitral valve prolapse, abnormal heart rhythms or heart failure
  • Bone loss, increasing risk of fractures later in life
  • In females, absence of a period
  • In males, decreased testosterone
  • Gastrointestinal problems, such as constipation, bloating or nausea
  • Electrolyte abnormalities, such as low blood potassium, sodium and chloride
  • Kidney problems
  • Suicide

If a person with anorexia becomes severely malnourished, every organ in the body can be damaged, including the brain, heart and kidneys. This damage may not be fully reversible, even when the anorexia is under control.

In addition to the host of physical complications, people with anorexia also commonly have other mental disorders as well. They may include:

  • Depression, anxiety and other mood disorders
  • Personality disorders
  • Obsessive-compulsive disorders
  • Alcohol and substance misuse

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